Credentialing and Provider Enrollment in 2018: Three Key Industry Survey Findings

April 1, 2021
April 1, 2021

Medical groups, hospitals, and healthcare organizations are facing an uncertain healthcare environment, escalating costs, and declining reimbursements. These organizations continue to seek strategies and solutions to decrease costs, increase revenue, and accelerate their provider enrollment process in order to obtain more timely reimbursement.

It is against this backdrop that VerityStream examine the current and changing landscape of provider enrollment and the implications for medical groups, hospitals and healthcare organizations. We present our research collected in early 2017 by VerityStream from 505 credentialing and provider enrollment professionals throughout the U.S. who indicate that creating efficiency and automation are higher priorities in their organization than in recent years.

Here are three important observations from our research:

  1.  Most organizations indicate their provider enrollment process is “adequate” and concede that improvement opportunities exist.
    When asked to assess the effectiveness and efficiency of their organization’s provider enrollment process, 63.7% rate their organizational process as adequate. However, 21.4% rate their organization as challenged, and 3.0% say that immediate and widespread improvement is urgently needed. Interestingly, only 4.1% rate their process as best-in-class.
  2.  Almost two-thirds of organizations indicate that improving the provider enrollment process is a higher priority than one year ago.
    On an item asking respondents to reflect on the past year in regard to provider enrollment as a priority for their organization, a solid 64.3% agree that it has become a higher priority.
  3. By far, the top priority for improvement is reducing the time required to enroll a provider.

    Respondents were asked to provide an importance rating on a range of items about processes, as shown in the table below. The item with the highest importance was “reducing time to enroll provider” (81.2% very important). Other items considered “very important” by more than half of respondents included:

    • Improving provider satisfaction with the credentialing and enrollment process
    • Implementing process efficiencies to improve the financial results related to employing physicians and/or owning physician practices
    • Reducing required resources and administrative costs through automation and process simplification
    • Maintaining an accurate provider directory (provider plan participation and office locations) on your website to support patients’ decision-making
    • Tracking metrics, benchmarks, and provider enrollment data to drive efficiencies and decrease onboarding time 

About VerityStream

VerityStream delivers enterprise-class solutions that are transforming credentialing, enrollment, privileging, and evaluation for healthcare organizations across the United States. We currently serve over 2,500 hospitals and 1,300 outpatient care settings in the U.S. including ambulatory surgery centers, urgent cares, and medical groups. VerityStream and our solutions resulted from the merging of Sy.Med, HealthLine Systems, Morrisey, and CredentialMyDoc representing over 75 years of industry experience. HealthStream, (NASDAQ: HSTM), based in Nashville, TN, is our parent company, supporting us through innovation, investment, and the development of market-leading products. VerityStream has over 225 employees spanning headquarters in Boulder, CO and satellite offices in San Diego, CA; Nashville, TN; Chicago, IL; and Savannah, GA.